What causes my post-ACDF neck pain after years?

Question

Hello doctor,

I had an ACDF of C3-C7 seven years back. After the surgery, I have had chronic muscle spasms, numbness, and pain on the left side of the neck. For the last five months, I have had increased tenderness in the left neck and shoulder.

For the past week, I have had excruciating pain running from the left side of my neck down to my left scapula, and it is more severe behind the left scapula. MRI and myelogram show foraminal impingement at C4-C6.

What could be the reason for this severe pain? Currently, I am taking Neurontin 600 mg, Robaxin 1000 mg, and Ibuprofen 600 mg.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

Your first query consult is on us!

You still have cervical central canal and foraminal stenosis between C5-C6 post-surgery which is the reason for your pain. You need to continue the medicines. You may have neck pain post one year of C4-C7 fusion. I will suggest you some precautions and exercises. If they do not work then re-surgery is the only option to try and reduce the stenosis and narrowing. There is no guarantee that the symptoms will vanish after re-surgery as there can be permanent damage to the nerve from foraminal stenosis which can never recover.

I suggest you follow a few instructions mentioned below for neck pain.

Avoid lifting heavy weights.
Avoid arching your back. Instead, bend your knees to pick up something from the floor.
Avoid sitting for long hours.
Avoid two-wheeler rides.
Improve your posture while sitting. Try to sit up with your back straight.
Try to get up from your chair once every 20 minutes, take a quick walk, and then continue working. Always sit on a chair with back support.
Do not get up suddenly from a sleeping position. Instead, turn to the side and then get up.
Take bed rest only if you have severe pain.
Do hot fermentations over the affected area, at least twice daily.
Apply Oxalgin (Diclofenac sodium, Methyl salicylate, and Menthol) gel twice daily on the affected area.

I suggest you take the following medications mentioned below.

Take tablet Pregabalin 75 mg at night before food for 15 days.
Take tablet Shelcal CT (calcium and vitamin D3) in the morning before food for 30 days.
Take tablet Vitamin D 60K once daily for 10 days, followed by once a month for 11 months.

Take these tablets only if you are not allergic to them. Also, do not take these tablets if you have bronchial asthma.

You can do physiotherapy (core strengthening exercises, neck rotations, shoulder shrugs, and shoulder rotations) under the guidance of a physiotherapist. Physiotherapy should be stopped once the pain reduces. Jogging, running, and weight lifting may aggravate back problems.

Kindly consult a specialist, talk to them, and take medications with their consent.

I hope this has helped you.

Thank you.